NPIMap

Organization Active NPI

Precious Haven, Inc.

  • Mental Illness Community Based Residential Treatment Facility
  • Fayetteville, NC
National Provider Identifier
1679802920
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
License
MHL-026-673 Issued in NC
Legal business name
PRECIOUS HAVEN, INC.
Practice address
7762 Hazelwood Ave
Fayetteville, NC 28314-6246
Phone
(910) 868-6092
Fax
(910) 868-8882
NPI assigned
Dec 16, 2009
Last updated
Dec 16, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Melissa M. McAllister
Title
Director/Owner
Phone
(910) 868-6092

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X MHL-026-673 NC Primary

Addresses

Primary practice location

7762 Hazelwood Ave
Fayetteville, NC 28314-6246

Mailing address

PO Box 25821
Fayetteville, NC 28314-5013
Phone (910) 868-6092

Other identifiers 1

IdentifierTypeStateIssuer
8301769MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Precious Haven Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1679802920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25821",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283145013",
            "telephone_number": "910-868-6092",
            "fax_number": "910-868-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7762 HAZELWOOD AVE",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283146246",
            "telephone_number": "910-868-6092",
            "fax_number": "910-868-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECIOUS HAVEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "MCALLISTER",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "910-868-6092",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-026-673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8301769",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.